Ready – Set – Where Are We Going?

Just how prepared is the staff at your mom’s nursing home should the worst happen?   Suppose a tornado bears down on the facility, or flood waters inundate its location, closing bridges and roads for miles around?  What if the power should fail, taking out the lights as well as the heat, during a major snow storm and the plows can’t keep up with the drifts and downed tree limbs?  How long will the generators last?  What about an earthquake or fire?  Unlikely?  Maybe.  But still…

Nature does what it will, when it will.  Emergencies and natural disasters are a fact of life.  And long-term care facilities are responsible for the safety of their elderly and often frail residents, both on-site and – should it come to it – during and after their emergency evacuation to another location.  Imagine organizing such a process.  Many residents cannot walk on their own, are dependent on all sorts of life-sustaining medical equipment, are disoriented, perhaps sedated and frightened, or have very challenging cognitive impairments because of Alzheimer’s or dementia.  Planning and effecting such an exodus takes plenty of preparing well in advance — something that cannot be figured out only after a scary weather bulletin crosses a screen.

The great folks at have compiled a list of questions that concerned caregivers might pose when deciding on a long-term care facility for a  loved one.   Disaster planning and preparation is not a sideline or an afterthought.  It is a basic part of any good facility’s day-to-day management.  Don’t feel awkward or pushy asking about their preparedness plans, either.  They won’t hold it against your loved one if you show that you are a concerned and educated caregiver.  But if you think they might, then don’t send your senior there!

General Emergency Planning

  • Plans for emergency evacuation and ‘sheltering in place’ will vary according to the actual emergency being faced: hurricane, fire, tornadoes, terrorism.   Ask what is in place for each type of situation.
  • How are these plans coordinated with community resources – the city, county and state emergency management groups?

Staff Training

  • Are evacuation drills practiced with residents and staff?  How often?
  • What are the training procedures for staff related to emergency evacuations?
  • Are there enough staff members on hand during all shifts to carry out the emergency plan?  Suppose a fire breaks out at two in the morning.  Will the skeleton staff be able to handle this emergency on its own?  Emergencies do not wait for full staff rosters or convenient times of day!

Family Communication

  • How, how often, and when does the care facility review its emergency plans with the residents?
  • How and when, and by whom, will family members of residents be notified about their loved one’s status and whereabouts during an emergency?
  • Is there a phone number or other link for out-of-town family members to call or use for information?
  • Do family members have the right to evacuate their loved one on their own and move them to a special needs shelter if they decide to do so?

On-site resources

  • What about emergency backup power systems or generators at the facility?  How long can they provide their own power should the main systems fail?  What parts of the facility will have power?
  • Are extra medications (at least a two-week supply for each resident) stored on-site?  Who oversees this?
  • How much emergency oxygen is available in portable cylinders?
  • In a multi-level building, should the elevators not be working, what procedures are in place for quickly and safely evacuating physically impaired residents by using the stairs instead?
  • Does each resident have emergency and first aid kits in their rooms?  These emergency kits should contain adequate clothing, toiletries, a working flashlight, up-to-date ID and other essential supplies.

Evacuation Procedures

  • Are contracts in place with transportation services and other appropriate facilities that will provide housing for displaced residents?
  • Does the contractor providing the transportation have enough vehicles to transport all the residents?  This is especially important to know in case the company is also contracted to supply transportation to other nursing homes or care facilities –  there may be a shortage in case of a regional disaster or weather event.
  • How are those residents who are on life-support or receiving hospice care to be transported?
  • Many evacuations must take place quickly.  What procedures are in place to make sure no residents are left behind or are overlooked in the scurry to round up everyone?  Some patients may wander off, be left in bathrooms or hallways, return to their rooms to retrieve belongings — how will everyone be accounted for?
  • How will residents be identified in an evacuation?
  • How will the residents’ medical information, charts and supplies be transported?
  • Can family members meet residents at a designated location?  Will they be able to help loved ones at the facility prepare for leaving?
  • Does everyone know the location where the residents are going?  Are they staying together or being divided among several sites?
  • Will a trained staff member or employee ride with the residents in each vehicle to administer medication or assistance as needed?
  • What permanent identification will residents be wearing?

Special thanks to Marlo Sollitto,


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